HomeMy WebLinkAbout04-28-14 (2) e
J 1505610105
REV-1500 Ex(e2-12)(9)
OFFICIAL USE ONLY
PA Department of Revenue pennsylvanfa Co ty Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
Harrisbuurg rg, 2
Po eD t RESIDENT DECEDENT I /3
P PA A 17128-0601
ENTER DECEDENT INFORMATION BELOW
09/11/2013 10107/1922
Decedent's Last Name Suffix Decedent's First Name MI
McMillen Carolyn O
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
N/A
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
CID 1.Original Return O 2, Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
D)p 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Robert R. Black, Esquire (717) 24,x,3727
0 :O
C'> = Fq
REGISTER ORW Ur$USE ONLY
G =D G7 CD
03 L7 p
O
First Line of Address fV m rn
36 South Hanover Street rn CO >s o
D 7 p
Second Line of Address � 3 n
City Or Post Office State ZIP Code O ~DATE Trtt-EP_
Uri 9 F—' rr
Carlisle PA 17013 Cn
Correspondent's e-mail address:
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaratlon of preparer other than the personal representative is based on all information of which preparer has any knowledge.
5 NATURE OF PERSON RESPONSIBLE FOR FILING RETURN ATE
.%k.� Gti a rlo�7e
ADDRESS
60 Conw a St et, Carlisle, PA 17013 12624 Walnut Bottom Road, Carlisle, PA 17015
SIGNATU F THRT N E 5 TIVE �C�P, TE /
ADDRESS / ly'
36 South Hanover Street, Carlisle, PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
L1505610105 1505610105 J
r•
J 1505610205
REV-1500 EX(Fl)
RECAPITULATION
1. Real Estate(Schedule A). .. .. . .. ... . . . 0.00
2. Stocks and Bonds(Schedule B) . . . . . . .. _. . .. . . .. . . ... .. . . .. . .. . . . . . 2. 78,581.47
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. 0.00
4. Mortgages and Notes Receivable(Schedule D) .. . .. .. . .... . . .. . . . . . . . 4. 0.00
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). ... . . . 5. 79,311.86
6. Jointly Owned Property(Schedule F) O Separate Billing Requested .. . . . . . 6. 0.00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested.. .. . . . . 7. 33,644.45
8, Total Gross Assets(total Lines 1 through 7).. . . . . .. . .. .... .. ... .. . . . .. . 8. 191,637.78
9. Funeral Expenses and Administrative Costs(Schedule H).... .. . .. . .. . ... . . . 9. 20,677.61
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1). . . . . . . .. . .... . 10. 8,312.50
11. Total Deductions(total Lines 9 and 10). . .. . .. . ... .. . ... . . . 11. 28,990.11
12, Net Value of Estate(Line 8 minus Line 11) . .. . . . .. . .. . ... . . . .. . .. . . . . . 12. 162,547.67
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) . . . .. .... . .. . . .. . . ... . . 13. 0.00
14. Net Value Subject to Tax(Line 12 minus Line 13) .... .. ... .. . . ... ... . . . . 14. 162,547.67
TAX CALCULATION•SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.0_ 15.
16. Amount of Line 14 taxable
at lineal rate X.0_ 16.
17. Amount of Line 14 taxable
at sibling rate X.12 17.
18. Amount of Line 14 taxable 162,547.67 18
at collateral rate X.15
19. TAX DUE . ... . . .. .. . . . . . . . . .. . . .. .. . 19. 24,382.15
.. . . . . .. . .. . .. . .. . .. . . . . . .. .
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
1505610205 1505610205
REV-1500 Ex(R) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Carolyn Q.McMillen
STREETADDRESS
Bethany Village, 5225 Wilson Lane, Suite 335
Cll'1' -� STATE .l ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 24,382.15
2. Credits/Payments
A.Prior Payments 20,000.00
B.Discount 1,052.60
Total Credits(A+B) (2) 21,052.60
3. Interest
(3)
4. If Line 2 is greater than Line t+Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 3,329.55
Make check payable to: REGISTER OF WILLS,AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred...................................................,....................._.............. ❑ 0
b. retain the right to designate who shall use the property transferred or its income ..................................._...... ❑ N
c. retain a reversionary interest ............................................................................................................................. ❑ 0
d. receive the promise for life of either payments,benefits or care?..................................................................... ❑
2, If death occurred after Dec.12,1982,did decedent transfer property within one year of death
without receiving adequate consideration?....................................................................................._......,...........,... ❑
3. Did decedent own an"in trust for'or payable-upon-death bank account or security at his or her death?.......
....... �❑
4. Did decedent own an individual retirement account,annuity or other non probate property,which
contains a beneficiary designation? ............................................._.................................,......._..........._..........___. ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 PS.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)3.A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1503 EX+(B-10)
pennsylvania SCHEDULE B
DEPARTMENT OF INHERITANCE REVENUE STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Carolyn O. McMillen 21-13-1020
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 730 Shares of Blackrock LTD Duration Inc Tr(BLW)@ 17.12(Oppenheimer Brokerage Acct 12,497.60
A09-0006659
2 207.585 Shares of Invesco U.S.Mortgage Funds Class A(VKMGX)@12.53 2,601.04
3 316.809 Shares of DWS GNMA Fund-S(SG-INX)@14.23 4,508.19
4 314.933 Shares of DWS Core Equity Fund-S(SGDGX)@22.300 7,023.01
5 1.166956 Shares of Blackrock LTD Duration Inc Tr Acct 0000000388 @ 17.12(see attached) 19.98
6 908.858 Shares of Fidelity GNMA Fund Acct 2BQ604186 @11.12 10,106.51
7 119.755 Shares of Vangard 500 Index Fund Acct 09879410453 @156.36(see attached) 18,724.89
8 401.255 Shares of Vangard Extended Market Index Fund#09879410453 @57.57(see attached) 23,100.25
TOTAL(Also enter on Line 2, Recapitulation) $ 78,581.47
If more space is needed, insert additional sheets of the same size
• REV-1508 EX+(o8-1z)
� pennsylvania
SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Carolyn 0. McMillen 21-13-1020
Include the proceeds of litigation and the date the proceeds were received by the estate,
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Cash-Oppenheimer&Co.Inc.-Brokerage Acct A09-0006659 707.41
2. Soveregin Bank-Checking Acct 2331026971 16,542.12
3, PNC Bank-Checking Acct 5140117588(see attached letter) 52,945.89
4. PNC Bank Premier Money Market Acct 5130064486(see attached letter) 1,063.10
5. Personal property-Ibis Appraisal Services(see attached appraisal) 7,917.00
6, Capital Blue Cross refund 136.34
TOTAL(Also enter on Line 5, Recapitulation) $ 79,311.86
If more space is needed, use additional sheets of paper of the same size.
' REV-151.0 EX+(08-09)
pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INRERETANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Carolyn 0. McMillen 21-13-1020
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION THEIR PROPERTY DATE OF DEATH %OF DECO'S EXCLUSION TAXABLE
Itft1.WE)HE NAME OF TMNAC-.A,THEIR TIE DEED FOR TO DECEDENT AND
NUMBER THE DATEDF TRANSFER Anpa Amer of THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF PPR1cABlE VALUE
1. ING USA Annuity and Life Insurance Company-Contract No. 21,108.09 100 0.00 21,108.09
NGK0000139548(see attached letter)
2 Sovereign Bank IRA CD Acct 2338110618(see letter attached at Schedule E) 12,536.36 100 0.00 12,536.36
TOTAL(Also enter on Line 7, Recapitulation) $ 33,644.45
If more space is needed,use additional sheets of paper of the same size.
REV�1.511 EX+(0843)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Carolyn O. McMillen 21-13-1020
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Myers-Harner Funeral Home-funeral expenses 343.00
2. Bethany Village-funeral luncheon 431.49
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 8,660.00
Name(s)of Personal Representative(s) Gail M. Black & Charlotte M. Klein
Street Address 60 Conway Street 12624 Walnut Bottom Road
City Carlisle _ -_........ . State__PA_ ZIP.17013-
Year(s)Commission Paid: 2014
2. Attorney Fees:
8,660.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) 0.00
Claimant NIA
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 1,695.47
5. Accountant Fees: 0.00
6., Tax Return Preparer Fees: 500.00
7 Ibis Appraisal services-personal property appraisal 150.00
B. Thomas Klein-moving expenses 65.65
9. Orrstown Bank-bank charges 14.00
10. lost stock certificate 36.00
11. Gail M. Black-reimburse-death certificates 56.00
12. PA Department of Revenue 2013 income tax 66.00
TOTAL(Also enter on Line 9, Recapitulation) $ 20,677.61
If more space is needed,use additional sheets of paper of the same size.
REV-1512 Ex+(12-12)
pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHEMANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Carolyn 0. McMillen 21-13-1030
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Omnicare King of Prussia-health care 968.72
2. Bethany Village-health care 6,614.03
3. Bethany Village-health care 267,75
4. Bethany Village-health care 462.00
TOTAL(Also enter on Line 10, Recapitulation) $ 8,312.50
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
' i_`j pennsylvania
SCHEDULE ]
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Carolyn O. McMillen 21-13-1020
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustees) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
I. Tomilyn Fay Forbes, 178-46-4746,W59 N450 Hilgen Avenue,Cedarburg, niece ring plus 20%
WI 53012
2. Bonita Jean Smith,177-48-3344,220 Gotschal Road,Danville,PA 17821 niece 20%
3. Kathleen Campbell Brennen, 190-50-6857,64 E Euchlan Avenue#152 niece 20%
Exton,PA 19341
4. Gail McMillen Black, 176-34-7909,60 Conway Street,Carlisle,PA 17013 niece ring plus 20%
5. Charlotte McMillen Klein,291-40-8430,2624 Walnut Bottom Road, niece ring plus 20%
Carlisle,PA 17015
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
0.00
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
0.00
TOTAL OF PART n—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-15DO COVER SHEET. $ 0.00
If more space is needed,use additional sheets of paper of the same size.
,
Sovereign Bank
ESTATE OF Carolyn 0. McMillen
SOCIAL SECURITY#: 185-28-4716
DATE OF DEATH: September 11, 2013
Account#: 2331026971 Type: Checking Open date: 6/30/1992
In the name of. Carolyn 0. McMillen
Date of Death Balance: $16,540.93
Int.(YTD) from 1/1/2013 to 9/6/2013 $1.19
Accrued interest to date of death: $0.03
Otherinfo: Account Closed 09/25/2013
Account#: 2338110618 Type: IRA CD Open date: 3/2/1995
In the name of: Carolyn 0. McMillen
Date of Death Balance: $12,364.19
Int.(YTD) from 1/1/2013 to 8/29/2013 $162.98
Accrued interest to date of death: $9.19
Other Info: Primary Beneficiary: Estate of Carolyn 0. McMillen
Page 1 of 1
• (D PNC BANK
Brianna Nornhold
Customer Service Reprosentative
NMLS 10 1081462
T717-243-6023 F717-243,3520
t�PNC b.1tvK To: bria nna.nornholdQepnc.com
` Member of The PNC Financial services Group
105 Noble Boulevard U1-U676-01.1
suh;ect. Carlisle Pennsylvania 17013
Estate of Carolyn O. McMillen
Date of Death: 09/11/2013
1. Interest checking
2. 5140117588
3. Carolyn O. McMillen
4. Not a joint account
- ----5 Balance as of-date of-death: $52,945.89 _.
1. Premium Money Market
2. 5130064486
3. Carolyn O. McMillen
4. Not a joint account
5. Balance as of date of death: $1063.10
Decedent processing was done and accounts were closed as of 09/23/2013
Brianna Nornhold
Customer Service Associate
Carlisle Branch
NMLS# 1081462
105 Noble Blvd.
Carlisle, PA 17013
P 717-243-6023
F 717-243-3520
SUMMARY APPRAISAL REPORT
PERSONAL PROPERTY ESTATE
Personal Property of the Estate of
Carolyn 0. McMillen, deceased
Bethany Village: Maplewood Assisted Living
5225 Wilson Ln. Suite 335
Mechanicsburg, PA 17055
Personalty Currently Located at:
Bethany Village: Maplewood Assisted Living
5225 Wilson Ln. Suite 335
Mechanicsburg, PA 17055
Client:
Gail Black, Executrix
Intended Users:
Gail Black, Executrix
Robert Black, Esq.
Effective Date of Appraisal:
d.o.d. September 11, 2013
Date of Report:
September 22, 2013
By:
leis Appraisal
Services
145N HaaoverSt
P.O.Box 24
Car I' PA 17013
(717)20=3474
info @ibisappraisals.com
wwwdbi5apprrisa1s,com
Ibis Appraisal Services September 22,2013
'Me Miillen tstate' Page l of 15
;.1
APPRAISAL SUMMARY
It is in my opinion, that as of the d.o.d. September 11, 2013 and reported on September 22, 2013,
the Fair Market Value of the Estate Personal Property of Carolyn 0. McMillen Bethany Village:
Maplewood Assisted Living, 5225 Wilson Ln. Suite 335 Mechanicsburg, PA 17055:
(Seven Thousand Nine Hundred Seventeen Dollars and Zero Cents)
($7,917.00)
Ibis Appvaisaf
S"Vi s
ACyssa L. ne ISM AM
ISf7 cc ite f Member
Di e or c� CEO
L
The report must he read in its entirety, The Appraisal Summary ONLY is not the
appraisal report.
Ibis Appraisal Services September 22, 2013
McMillen Estate Page 5 of 15
ING. `:: _
December 17, 2013
LAW OFFICES OF
LANDIS & BLACK
36 SOUTH HANO VER ST
CARLISLE, PA 17013
ING USA Annuity and Life Insurance Company
Decedent: Carolyn McMillen
Contract Number: NTGK00001 3 9 54 8
Claim Code: 03010
Dear Mr. Black,
We have received your recent inquiry regarding the commuted value on the above value represents annuity,
contract. As of 09/11/2013 the Commuted Value is 521,108,09. The commuted
the current value of the future annuitization payments,
This is a quote only, and is based on the rates and values as of the above value and date. Market
fluctuation and rate changes may cause the income quoted to be more or
this letter. less than indicated in
If you have questions regarding this information, please contact our Customer Contact Center,
available Monday— Thursday, 8:30 a.m. to 6:30 p.m., Eastern Time, and Friday, 8:30 a.m. to 5:30
p.m., Eastern Time. Call 800-369-5303 and press 3 to identify yourself as a beneficiary. When
Prompted, enter the five digit Claim Code above and press#. Your call will be addressed by a
claims specialist.
Sincerely,
ustomer Service
ING
Annuities ismed by ING USA Annuity and Lif,
/OOlkb e/nsuranx Compgny.
,Fide/i[�
December 11, 2013
ROBERT R BLACK
C/O LAW OFFICES LANDIS & BLACK
36 S HANOVER ST
CARLISLE, PA 17013
Dear Robert R Black:
As requested,please find the Date of Death Account Valuation for the Estate of Carolyn O McMillen.
Estate Valuation
Account Number: 2BQ604186 Individual Value Date: 09111/2013
Share
Symbol Security Description Qty Value Price
FGMNX FIDELITY GNMA FUND 908.858 $10,106.51 $11.12
Total Securities: $10,106.51
Interest in the amount of$5.62 is not included in the above amount.
All values included represent the Fair Market Value (FMV)of assets held in the account as of the owner's date of
death.The report does not include Limited Partnerships, Options,Precious Metals or Worthless Security positions
held in the account as of the date of death nor any accrued dividends not distributed prior to the date of death. Values
for any accounts that only hold those asset types are therefore, not included.
Fidelity does not warranty the accuracy of this information for any particular purpose nor does Fidelity provide legal
or tax advice. Consult with an attorney or tax professional regarding any specific legal or tax situation.
FOR TRUST ACCOUNTS: Please note that if the account on the valuation is a trust registration,then a
separate letter of instruction to update cost basis must be submitted. The letter must include the following three
items:
1. A statement that the trust qualifies under the IRS regulation to receive a step up
2. The percentage of the trust that should be stepped up
3. The signature of a currently acting trustee
The request to update cost basis should be sent directly to:
Fidelity Investments
ATTN: Cost Basis
100 Crosby Pkwy, Mailzone KC 1 K-PR
Covington, KY 41015
We hope this information is helpful. If you have any questions regarding this matter or need instructions on how to
transfer the ownership of the accounts not yet transferred, please call us at 800-544-0003. Fidelity Inheritor Services
Representatives are available Monday through Friday, from 8:00 A.M. to 6:30 P.M. Eastern time, or you may visit
our website at www.fidelity.com and search under"change account registration" for additional information.
Brokerage Services provided by Fidelity Brokerage Services LLC Member NYSE,SIPC
Clearing,custody and settlement services by National Financial Services LLC Member NYSE:,SIPC
P.O.Box 770001,Cincinnati,OH 45277-0034
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access to Computershare's Investor CentroM website. Use this simple tool to `���oo'
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LANDIS&BLACK
ATTN ROBERT R BLACK
36 SOUTH HANOVER STREET
CARLISLE PA 17013
November 13,2013
Company: BLACKROCK LIMITED DURATION INCOME TRUST
Registration: CAROLYN 0 MCMILLEN
Holder Account Number: C0000000388
Document I.D.: 13312WF00294078
Our Reference: BLW/0002871666/3/
Dear Sir/Madam:
Thank you for contacting Computershare, the transfer agent for BLACKROCK LIMITED DURATION INCOME
TRUST. We appreciate the opportunity to be of service to you.
Below is the account balance information you requested as of September 11, 2013 for the above account.
Shares Held by Agent: 1,166956
Shares Held in Certificate Form by Holder: 0
Total Shares: 1.166956
Closing Price Per Share: $17.12
Please be advised that in order for the shares to be sold, they must be transferred to a new holder.
Attached are the form and instructions needed to transfer stock to a new account or another holder.
Alternatively, for most accounts, the Computershare stock transfer wizard will walk you through the
transfer process and assist you in completing the necessary documentation to complete the transfer.
Please see our website at www.transfermystock.com.
Should you have other account related questions, please call us at (800) 699-1236 during regular business
hours, Please note that any available representative can assist you.
Sincerely,
00 - 591*611
Service Representative
Enclosure: US Holder-Deceased Transfer Package.pdf
Vanguard®
November 12, 2013 Po. Box 2600
Val,ey Forge, PA 19482-2600
www.vanguard.com
GAIL M BLACK
60 CONWAY ST
CARLISLE PA 17013-2805
Re: Estate of Carolyn 0. McMillen
Dear Ms. Black:
We are responding to a letter we received requesting a valuation of Carolyn O,
McMillen's Vanguard account. The information is in the table below.
As of September 11, 2013, the number of shares, the price per share, the value of
each fund, and the accrued dividends (if applicable) were as follows:
Carolyn O. McMillen—Individual Account 09879410453
Fund Name Shares Price Value Accrued
500 Index Fund Adm 119.755 $156.36 Dividends
Extended Mkt Index Adm 401.255 $57.57 $18724.89 —
$23,100.25
If you have any questions about a transfer or a transition of assets, please call us
at 888-237-9045, ext 42838. Specialists are available on business days from 8
a.m. to 8 p.m., Eastern time.
Sincerely,
Transition Team
Vanguard
do
52489040
LAST WILL AND TESTAMENT
OF
CAROLYN O. MCMILLEN
I, CAROLYN O. McMILLEN, of 2013 Harvard Avenue, Camp Hill,
County of Cumberland, Commonwealth of Pennsylvania, being of sound
mind and memory, do make, publish and declare this my Last Will and
Testament, hereby revoking and declaring null and void any and all
Wills and Codicils by me at any time heretofore made.
it FIRST: I direct my Executors to pay my just debts, the
expense of my last illness and my funeral expenses from the
property passing under this Will as an expense and cost of
administering my estate, as soon after my death as may be found
convenient. Now I direct that a brief, closed casket service be
held following my death and that my burial be at the Rolling Green
Cemetary.
SECOND: I give, devise and bequeath all that I possess in
this world, including both real and personal property, to my five
(5) nieces, GAIL McMILLEN BLACK, of 60 Conway Street, Carlisle,
Pennsylvania, 17013, CHARLOTTE MCMILLEN KLEIN, of 2624 Walnut
Bottom Road, Carlisle, Pennsylvania, 17013-9239, TOMILYN FORBES,
LAW OFFICES
TRICK F.LAUER,JR. PAGE ONE OF SIX
Attorney at Law
2198 Market Street
Wee Building
amp Hill,PA 17011
(717)783-1800
3 South Duke Street
Xmk,PA 17401
(717)8443-1788
of W59 N450 Hilgen Street, Cedarburg, Wisconsin, 53012, BONNIE
SMITH, of R.A. #3 Box 48, Danville, Pennsylvania, 17821, and
KATHRYN BRENNEN, of 427 Grove Street, Bridgeport, Pennsylvania,
19405, living at the time of my death, to share and share alike,
per stirpes . If any of my nieces fails to survive me, then I give,
devise and bequeath their shares to their issue, per stirpes.
THIRD: Any and all payment or payments of any sum or sums,
whether in cash or in kind and whether for principal or income,
payable to my nieces, shall be made upon the sole receipt of the
respective individual to whom payment is made, and free from
anticipation, alienation, assignment, attachment, and pledge, and
free from control by the creditors of any such beneficiary.
FOURTH: My Executor(s) and Trustee(s) shall have the
following powers in addition to those vested in them by law and by
other provisions of this Will, applicable to all property, real,
personal and mixed and wheresoever situate, whether principal or
income, exercisable without court approval, and effective with
respect to each item of said property, until actual distribution
LANO"TCFS thereof
TRICK F.LALTA JR
Atumey at Law A. To retain, as investments, any and all assets of my
6108 Market Street
Aat«sPA estate real personal or mixed, without regard to an principal
amp Hi]],PA 17011 � r p g y
(717)783.1800
PAGE TWO OF SIX
3 South Duke Street
York,PA 17401
(717)84e-1788
of diversification, and to purchase and acquire real or personal
property, and to hold any and all of such real and personal
property retained or acquired without making the same productive
of income;
B. To permit occupancy of any real estate retained or
acquired upon such terms and conditions as they shall deem proper;
C. To pay all taxes, charges, and expenses of
maintenance, upkeep, improvements, development, protection,
preservation and investment of any retained or acquired real or
personal property, such payments to be made from either principal
or income, as my Executor(s) shall determine;
D. To retain or invest any and all funds, whether
principal or income, in any real or personal property without
restriction to legal investments; to purchase investments as
premiums; to exercise all rights of a security holder or
shareholder in any corporation; and to lease, mortgage, pledge,
give options upon or sell, at public or private sale and without
approval of any court and without any responsibility to the buyer
LAW 0MCES or buyers to see to the application of the purchase price, any real
nucx F.LAVER,JR.
Attorney at Law or personal property, or portions thereof, irrespective of the
2109 Market street
amp Hill, A 17 PAGE THREE OF SIX
amp Hill,PA 31011
(717)769-1990
3 South Duke Street
York,PA 17401
(717)W-1799
manner of means by which the same was acquired by my said
Executor(s) ;
E. To make any payment or distribution herein provided
for in cash, kind, or partly in cash and partly in kind, at
valuations fixed by my Executor(s) at the time of said
distribution.
FIFTH: I name and appoint my nieces, GAIL MCMILLEN BLACK and
CHARLOTTE MCMILLEN KLEIN, to be Co-Executrix' of this, my Last Will
and Testament. Should either of my nieces fail to survive me, fail
to qualify, or cease to act as an Executrix, then I name and
appoint the remaining niece to act as sole Substitute Executrix.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
day of ` 1992 .
CAROLYNI McMILLEN
LAW OFFICES
.TRICK F.LAVER JR
Attorney at Lew
2108 Market Street
Aztec Building
.amp Hill,PA 17011
(717)788.1800 PAGE FOUR OF SIX
8 South Duke Street
York,PA 17101
(717)SWI788
SIGNED, SEALED, PUBLISHED and DECLARED by the above-named
Testatrix, CAROLYN O. McMILLEN, as and for her Last Will and
Testament, in the presence of us, who, at her request, in her
presence and in the presence of each other have hereunto subscribed
our names as witnesses .
I?A
WIT ESS ADDRESS
Ii'd»ynp
WITNESS g
ADDRESS ;
Sworn and affirmed to and acknowledged before me, by
Sce+l N• 1C$wff and Tv-ee
bhu.n
1992 . y L . '7cAes
of , this 19 day
N TARP PUBLIC
r!oTAn(a',
PATR= F LN.0°PI, R Ki'ii1RY FUnl.!U
SWATAfO, TQVurdSN!? BAUPHiN COLtN'IY f:^.
l.AW OFFICES
MICK F.LAUEB,.le.
Attorney at VM
2108 Market Street
Aztec Building
Camp Hill, 17011 PAGE FIVE OF SIX
(717)7633-183-1800
18 South Duke Sheet
York,PA 17401
(717)848-1799
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
I, CAROLYN 0. McMILLEN , the Testatrix, whose name is signed
to the attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
this instrument as my Last Will; and that I signed it willing and
that I signed it as my free and voluntary act for the purposes
therein contained.
CAROLYN ,q. MCMILLEN
Sworn to or affirmed to and acknowledged before me by CAROLYN O.
McMILLEN, the Testatrix, this 8 '' day of k6-4,,e , 1992 .
NOTARY
PUBLIC
LAW OFFICES
'AIRICK F.LAUEP,JR ,.
Attorney at lAw -.
2108 Market Street
Aztec Building
Camp Hill,PA 17011 PAGE SIX OF SIX
(717)783-1800
48 South Duke street
York,PA 17401
(717)848-17"
CODICIL TO LAST WILL AND TESTAMENT
OF CAROLYN O. McMILLEN
I, CAROLYN O. McMILLEN, of Bethany Village, Lower Allen Township,
Cumberland County, Pennsylvania, being of sound and disposing mind, do make, publish
and declare this as and for a Codicil to my Last Will and Testament dated February 18,
1992.
FIRST: I do hereby add to my said Last Will and Testament dated February 18,
1992, a new paragraph SIXTH as follows:
SIXTH: I give and bequeath my rings as herein and after set forth:
A. My mother's ring containing 2 diamonds: one being 1 and 1/3 carats and
the second being land 1/4 carats to my niece, Tomi Fay Forbes, of
Cedarburg, WI 53012;
B. My engagement ring containing a perfect diamond of.91 carats to my
niece Charlotte Klein, of Walnut Bottom Road, Carlisle, PA 17015;
C. My Aunt Margaret's ring containing 2 carats being 1 1&3/4 and 6 small
0.4 carat diamonds on the side to my niece, Gail M. Black, of 60 Conway
Street, Carlisle, PA 17013.
SECOND: Except as herein modified, I do hereby republish and redeclare my said
Last Will and Testament of February 18, 1992. nn
I have signed this Codicil this '�/Joday of IUV' H'l�/' 201 )x;
Carolyn O. Millen
Witness
44
Wit ss
ACKNOWLEDGMENT AND AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF CUMBERLAND SS.
I, Carolyn O. McMillen, the testatrix in, and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, having been duly qualified
according to law do depose and say.
(a) that I, the testatrix, do hereby acknowledge that I signed and executed the
instrument as Codicil to my Last Will, that I signed it willingly and as my free and
voluntary act for the purposes therein expressed; and
(b) that we, the witnesses, were present and saw the testatrix sign and execute
the instrument as Codicil to Last Will, that she signed it willingly and executed it as her
free and voluntary act for the purposes therein expressed; that each of us in the hearing
and sight of the testatrix signed the Codicil to Last Will as a witness and that to the best
of our knowledge the testatrix was at that time 18 of more years of age, of sound mind
and under no constraint or undue influence.
ro�p Q/�Z -�.'s�j.(��
Y cMillen Testatrix
ear
Witness
Witn s
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Notary Public
NOTARIA; SEAL
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